Inflammatory myofibroblastic tumors (IMTs) of the head and neck are frequent benign lesions and have been reported in various sites such as orbit, maxillary sinus, nasal cavity, buccal space, parotid gland, nasopharynx and larynx. However, the orbit is the most common location for IMTs in the head and neck 1, known as idiopathic orbital inflammation.
Please refer to the article on inflammatory myofibroblastic tumors for a broad discussion.
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Etiology
Some etiological factors have been reported, such as previous surgery or trauma, chronic infections and autoimmune diseases. A strong association with IgG4-related disease and chronic infection by Epstein-Barr virus has been suggested 2,3,4.
Clinical presentation
Regarding the mass's size, location, extension and aggressiveness, the clinical presentations vary from asymptomatic to local pain, redness, edema and mass effect. Additionally, they may associated with a general inflammatory response such as fever and weight loss.
Radiological features
MRI is the modality of choice for diagnosis and evaluation of the head and neck IMTs. CT has been accepted as an alternative radiological modality. On MRI and CT, IMTs often show a solid and heterogeneous enhancing appearance, accompanied by adjacent bone destruction and even intracranial extension 5,6.
Differential diagnosis
primary infection
Treatment
Administration of steroids, non-steroidal anti-inflammatory drugs or immunosuppressors often leads to a decrease in the size of the mass. Surgical resection is an alternative treatment for head and neck IMTs.
In patients with local recurrence or incomplete surgical removal, radiotherapy may be adjunctive therapy.
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